Provider Demographics
NPI:1639256258
Name:THE REDMOND FAMILY MEDICINE CENTER
Entity Type:Organization
Organization Name:THE REDMOND FAMILY MEDICINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FIXOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-316-2277
Mailing Address - Street 1:215 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2113
Mailing Address - Country:US
Mailing Address - Phone:541-316-2277
Mailing Address - Fax:541-316-2278
Practice Address - Street 1:215 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2113
Practice Address - Country:US
Practice Address - Phone:541-316-2277
Practice Address - Fax:541-316-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR129392Medicare UPIN